Sniffing Out Alzheimer’s

peanut-butter-memory-400x400A dollop of peanut butter and a ruler might be a way to confirm a diagnosis of early-stage Alzheimer’s disease.

Jennifer Stamps, a graduate student in the McKnight Brain Institute Center for Smell and Taste, came up with the idea of using peanut butter to test for smell sensitivity.  when she was working with Kenneth Heilman MD, a professor of neurology at the University of Florida.

One of the first places in the brain to degenerate in people with Alzheimer’s disease is the front part of the temporal lobe that evolved from the smell system. This portion of the brain is also involved in forming new memories. The ability to smell is associated with the first cranial nerve – the olfactory nerve.

Because peanut butter is a “pure odorant,” it is only detected by the olfactory nerve.

In a small pilot studypatients sat down with a clinician, a tablespoon of peanut butter and a metric ruler.

peanut butter testThe patient closed his or her eyes and mouth and blocked one nostril. The clinician opened the peanut butter container and held the ruler next to the open nostril while the patient breathed normally. The clinician then moved the peanut butter up the ruler one centimeter at a time during the patient’s exhale until the person could detect an odor.

The distance was recorded and the procedure repeated on the other nostril after a 90-second delay.

The clinicians running the test did not know the patients’ diagnoses, which were not usually confirmed until weeks after the initial clinical testing.

Patients in the early stages of Alzheimer’s disease had a dramatic difference in detecting odor between the left and right nostril – their left nostril did not detect the smell until it was an average of 10 centimeters (almost 4 inches) closer to the nose than the right nostril.

This was not the case in patients with other kinds of dementia. These patients had either no differences in odor detection between nostrils or the right nostril was worse at detecting odor than the left one.

Of the 24 patients tested who had mild cognitive impairment, which sometimes signals Alzheimer’s disease and sometimes turns out to be something else, about 10 patients showed a left nostril impairment and 14 patients did not. The researchers said more studies must be conducted to fully understand the implications.

At the moment, we can use this test to confirm diagnosis,” Stamps says. “But we plan to study patients with mild cognitive impairment to see if this test might be used to predict which patients are going to get Alzheimer’s disease.”

Many of the tests used to confirm a diagnosis of Alzheimer’s disease or other dementias can be time-consuming, costly, or invasive.  In contrast, according to the researchers their peanut butter and ruler test could be used by clinics that don’t have access to the personnel or equipment to run other, more elaborate tests required for a specific diagnosis.

peanut-butter-and-jelly-sandwich_0And of course there’s the benefit that you can eat the test afterwards!

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Like this post?  Check back on Monday for more ground breaking Alzheimer’s news.

Out Pacing Alzheimer’s

Woman and elderly mother talking to a doctorAlzheimer’s disease is the most common form of degenerative dementia, afflicting about 5.5 million Americans and costing more than $100 billion per year. In terms of U.S. health care expenditure it now ranks as the third costliest disease.

Alzheimer’s disease is not easily managed. It becomes progressively disabling with loss of memory, cognition, worsening behavioral function and a gradual loss of independent functioning. Currently there is no cure.

Kathy SandfordBut this may be all about to change. Last October, during a five-hour surgery at The Ohio State University Wexner Medical Center, Kathy Sanford became the first Alzheimer’s patient in the United States to have a pacemaker implanted in her brain.

Could this be the dramatic shift in the disappointing struggle to find something to slow the damage of this epidemic?  As yet, no one knows if it might work, and if it does, how long the effects might last.  Research is still in its infancy.

Dr. Douglas Scharre, neurologist and director of the division of cognitive neurology, and Dr. Ali Rezai, neurosurgeon and director of the neuroscience program are jointly conducting the study.

Sanford is the first of up to 10 patients who will be enrolled in the FDA-approved study to determine if using a brain pacemaker can improve cognitive and behavioral functioning in people with Alzheimer’s disease.

brain pacemakerThe study employs the use of deep brain stimulation (DBS), the same technology used to successfully treat patients with movement disorders such as Parkinson’s disease.

First, holes are drilled into the patient’s skull so tiny pacemaker wires can be implanted into just the right spot. A battery-powered generator near her collarbone then sends tiny shocks up her neck and into her brain.

It is hoped that zapping the brain with mild jolts of electricity will make the brain work better and stave off the cognitive, behavioral and functional effects of Alzheimer’s disease.

If the early findings that we’re seeing continue to be robust and progressive, then I think that will be very promising and encouraging for us,” says Ali Rezai MD, “But so far we are cautiously optimistic.”

Kathy Sanford says she volunteered for the study to help others avoid the angst she has suffered as Alzheimer’s slowly disrupted her life.  The Ohio woman’s early stage Alzheimer’s was gradually getting worse. She still lived independently, posting reminders to herself, but no longer could work. The usual medicines weren’t helping.
Her father is proud that his daughter is participating in the study. “What’s our choice? To participate in a program or sit here and watch her slowly deteriorate?” asked Joe Jester, 78.  He drives his daughter to follow-up testing, hoping to spot improvement.

cognitive testingSince having the surgery last October Sanford has undertaken a number of problem-solving tests while neurologists adjusted the voltage and frequency and watched her reactions.

She was cheered to see her test scores climb a bit during those adjustments. While she knows there are no guarantees, she says “if we can beat some of this stuff, or at least get a leading edge on it, I’m in for the whole deal.”

Her optimism and hope is shared by her neurologist. “We’re getting tired of not having other things work” said Douglas Scharre MD.  Alzheimer’s doesn’t just steal memories. It eventually robs sufferers of the ability to do the simplest of tasks.

Here’s hoping these brain pacemakers can reconnect some of the circuits and diminish such losses.

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